nita Dental Asst Unit Z05 Screening encounter at Dental Clinic. Reason Not Done: Unavailable Comments: Patient has had several call outs for his Dental A & 0 screening but has not been escorted to dental clinic. Cosign Required: No Completed by DeBruce, Juanita Dental Asst on 07/19/2019 13:49. Generate

ITE Provider: r b)(6); (b){?)(C) I Dental Asst Reg#: Facility: Unit: 76318-054 NYM 205 Comments: Patient has had several call outs for his Dental A & 0 screening but has not been escorted to the dental clinic. Cosign Required: No Completed b~""(b.,.,, >(5,.,... >: .,,.., (b>""' (7,..,.,)(c,.,...)--

WHITE Provider: r b)(G); (b)(7)(C) p ental Asst Reg#: Facility: Unit: 76318-054 NYM Z05 Comments: Patient has had several call outs for his Dental A & 0 screening but has not been escorted to the dental clinic. Cosign Required: No Completed b~~bl_r5_u _b)C-7J_cc_> --~ !Dental Asst on 07/19/2019 13:4

WHITE Provider: rb)(6); (b)(7)(C) I Dental Asst Reg#: Facility: Unit: 76318-054 NYM Z05 Comments: Patient has had several call outs for his Dental A & 0 screening but has not been escorted to the dental clinic. Cosign Required: No Completed by~~b~)(6~);=(b~)(7=)(~C)-~IDental Asst on 07/19/2019 13:49

Unit: 76318-054 NYM Z05 Screening encounter at Dental Clinic. Reason Not Done: Unavailable Comments: Patient has had several call outs for his Dental A & 0 screening but has not been escorted to Cosign Required: No Completed by Dental Asst on 07/19/2019 13:49. e dental clinic. Generated 07/19/201913

Unit: 76318-054 NYM Z05 Screening encounter at Dental Clinic. Reason Not Done: Unavailable Comments: Patient has had several call outs for his Dental A & 0 screening but has not been escorted to Cosign Required: No Completed by n 07/19/2019 13:49. e dental clinic. Generated 07/19/201913:49 by Burea

Unit: 76318-054 NYM ZO5 Screening encounter at Dental Clinic. Reason Not Done: Unavailable Comments: Patient has had several call outs for his Dental A & 0 screening but has not been escorted to the dental clinic. Cosign Required: No Completed by Dental Asst on 07/19/2019 13:49. Generated 07/19/20191